Women with chest pain could be less likely than men to receive recommended therapies from paramedics en route to hospital, a U.S. study suggests.

At the Society for Academic Emergency Medicine's annual meeting in New Orleans on Friday, researchers from the University of Pennsylvania school of medicine said women were significantly less likely to receive Aspirin and nitroglycerin while in the care of emergency medical service providers than men.

It's known that women may show different symptoms from heart attack than men and that women's symptoms may be attributed to less severe illnesses or injuries. But early intervention with Aspirin and nitroglycerin can prevent damage to cardiac tissue, since "time is muscle" for the heart, regardless of gender.

"Women with heart attacks have higher death rates than men, so these findings are very concerning," said lead author Dr. Zachary Mesiel, an emergency physician at the university's Institute of Health Economics.

"I suspect some of the treatment differences between men and women may be related to differences is the way the chest pain symptoms are interpreted, both by the providers and by the patients themselves," he added in release.

Monitoring equipment

In Canada and the U.S., cardiac monitoring equipment has been added to ambulances to send information about a patient's heart rhythm to the hospital as quickly as possible so staff can prepare to open blocked arteries. 

The study looked at 683 cases in 2006 and 2007. Researchers measured whether patients got Aspirin and nitroglycerin to relieve cardiac pain, or had IV lines placed to deliver medication.

The results were:

  • 24 per cent of women were given Aspirin compared with 32 per cent of men.
  • 26 per cent of women got nitroglycerin, compared to 33 per cent of men.
  • 61 per cent of women had an IV line placed, compared to 70 per cent of men.

Among women who ultimately were found to be having a heart attack when they arrived at emergency, none had received Aspirin beforehand.

After taking age, race and baseline medical risk into account, the gender gap remained. Whether the paramedic was male or female did not appear to change the findings.

Mesiel suggested that patients be direct and clear about their chest pain symptoms, "even if they feel like they are telling the same story over and over again."